﻿<%@ Page Title="" Language="C#" MasterPageFile="~/Views/Shared/Site.master" Inherits="System.Web.Mvc.ViewPage<MedicViet.Models.ServicesRegister>" %>

<asp:Content ID="Content1" ContentPlaceHolderID="TitleContent" runat="server">
    MedicViet - Đăng kí dịch vụ
</asp:Content>

<asp:Content ID="Content2" ContentPlaceHolderID="MainContent" runat="server">
    <td align="left" valign="top" id="sidebar">
        <ul class="sidebar-nav">
            <li><a href="/ServiceRegister">Đăng Kí Dịch Vụ</a></li>
            <li><a href="/Contact">Thông Tin</a></li>
        </ul>
    </td>
    <td align="left" valign="top" width="14">
        &nbsp;
    </td>
    <td align="left" valign="top" style="padding-top: 13px;">
        <div id="welcomezone">
            <h1>
                Liên Hệ</h1>
            <div style="padding: 10px 0 10px 0">
                <div>
                    <br>
                    <% using (Html.BeginForm())
                       { %>
                    <%: Html.ValidationSummary(true)%>
                    <table width="97%">
                        <tbody>
                            <tr>
                                <td width="145" align="left" valign="top" class="body" id="Company">
                                    <strong>Họ Và Tên:</strong>
                                </td>
                                <td width="280" align="left" valign="top">
                                    <%: Html.EditorFor(model => model.name)%>
                                    <%: Html.ValidationMessageFor(model => model.name)%>
                                </td>
                            </tr>
                            <tr>
                                <td align="left" valign="top" class="body" id="Contact">
                                    <strong>Ngày Sinh :</strong>
                                </td>
                                <td align="left" valign="top">
                                    <%: Html.EditorFor(model => model.birtDate)%>
                                    <%: Html.ValidationMessageFor(model => model.birtDate)%>
                                </td>
                            </tr>
                            <tr>
                                <td align="left" valign="top" class="body" id="Address">
                                    <strong>Email : </strong>
                                </td>
                                <td align="left" valign="top">
                                    <%: Html.EditorFor(model => model.email)%>
                                    <%: Html.ValidationMessageFor(model => model.email)%>
                                </td>
                            </tr>
                            <tr>
                                <td align="left" valign="top" class="body" id="Phone">
                                    <strong>Điện thoại : </strong>
                                </td>
                                <td align="left" valign="top">
                                    <%: Html.EditorFor(model => model.phoneNumber)%>
                                    <%: Html.ValidationMessageFor(model => model.phoneNumber)%>
                                </td>
                            </tr>
                            <tr>
                                <td align="left" valign="top" class="body" id="Email">
                                    <strong>Địa chỉ : </strong>
                                </td>
                                <td align="left" valign="top">
                                    <%: Html.EditorFor(model => model.address)%>
                                    <%: Html.ValidationMessageFor(model => model.address)%>
                                </td>
                            </tr>
                            <tr>
                                <td align="left" valign="top" class="body" id="Td1">
                                    <strong>Gói Dịch Vụ : </strong>
                                </td>
                                <td align="left" valign="top">
                                    <input type="radio" checked value = "Dịch Vụ Trọn Gói" name="services" id="services" />Dịch Vụ Trọn Gói  <br />
                                    <input type="radio" value = "Dịch Vụ Tiêu Chuẩn" name="services" id="services" />Dịch Vụ Tiêu Chuẩn <br /> 
                                    <input type="radio" value = "Quà Tặng Cuộc Sống" name="services" id="services" />Quà Tặng Cuộc Sống <br />
                                </td>
                            </tr>
                            <tr>
                                <td align="left" valign="top" class="body" id="Comments">
                                    <strong>Thông tin bổ sung : </strong>
                                </td>
                                <td align="left" valign="top">
                                    <%: Html.TextAreaFor(model => model.comment, new { cols = "25", rows = "6" })%>
                                    <%: Html.ValidationMessageFor(model => model.comment)%>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                </td>
                                <td>
                                    <input type="submit" name="submit" class="button" value="Gửi" />
                                </td>
                            </tr>
                        </tbody>
                    </table>
                    <% } %>
                </div>
                
            </div>
        </div>
    </td>
</asp:Content>
